Todd is the Director of Technology for the INSPIRE Network with David Kessler & Marc Auerbach. Todd was formerly the Faculty Advisor and Head Site Administrator for the website's predecessor, pemfellows.com. He lives in Pasadena, CA, with his partner and 2 ridiculous cats that are probably sitting on his head as you read this.

For those of you jr. or mid-level faculty who are thinking…what are the next steps for Academia? Or senior-level faculty who have been doing the same things for a decade or longer? Or even the spry, recently added faculty looking to promote past Clinical Instructor… all of these folks have academic promotion on their minds. Because PEM occupies an interesting clinical niche that is not standard throughout the US and Canada and abroad, there some interesting work that you have to do to at least begin thinking about promotion.

Most promotion details are housed somewhere deep in the University Faculty Affairs office or website. Often it’s outdated, because for clinician faculty, the rules change a lot. Here are the general principles of promotion that should apply to almost all academic faculty:

1. Promotions are ultimately decided at the University level. Like hallowed ivy-crusted formica-table “quadrangle” university level. Although university Promotions Committees will have people from the medical school, there will likely be panel members who are in different disciplines in science, humanities, etc. Most definitely there will be clinicians who are not in PEM, pediatrics, nor emergency medicine. They require guidance from your Department Chair to provide a reference frame for what journal articles carry high weight, what societies are academically strong, and what educational or community activities carry scholarly weight. If it’s unclear, it’s up to your CV and profile of activities to highlight the magnitude of scholarship.

2. Clinical Instructor: Roughly 20 – 30% of universities do not allow recent graduates from PEM fellowship to become Assistant Professor; instead, there is a Clinical Instructor designation. Alternatively, people may elect to be Clinical Instructor when graduating to exempt themselves from scholarly activity temporarily. In any case, Clinical Instructorships tend to last 5 years or less depending on the university promotion culture. Promotion into Assistant Professorship is relatively simple – typically no publications are absolutely required, but having none since fellowship will raise questions about your academic productivity. Letters of Recommendation usually come from local people, and your Division / Department / medical school will be your advocate in the University Promotions process.

3. Favoritism towards Publications: Just like most of life, any faculty member is judged most by the strength of peer-reviewed publications. In our field, peer-reviewed original research carries the most weight, but even in fields like English Literature, a faculty member needs to publish their own essays or books before promotion to Associate Professor and higher. However, please see the previous Blog Posts that provide suggestions on what counts as scholarly publication – particularly for those of us who are not Clinician-Investigators – such as case reports, case series, curricula, position papers, review articles, textbook chapters, etc. Those going for full Professor will need to focus most on peer-reviewed articles as much as possible, unless you are on a specifically educational track. The number one reason faculty members are not recommended for promotion is insufficient peer-reviewed publications.

4. Notoriety: Promotion beyond Assistant Professor means you need to be regionally or nationally known for something. Preferably something scholarly and not evil. Depending on your academic track, you will need to know 3 to 8 other faculty members outside of your university, at a faculty rank higher than you, to comment on your scholarly work. The caveats – you can’t be actively working with them on a project, and you shouldn’t contact them about it. The university or your Department will do that for you. This is to ensure that your scholarship represents something that carries influence or expertise that goes beyond the university halls. Preferable to Associate Professor and definite to Professor levels: some example of leadership. The more multi-center, the better. This should drive your Division or Department to fund travel to conferences for you over funding travel for non-academic clinicians.

5. Tracks: Each faculty track as detailed in a previous post will have their own definitions for promotions. Promotion along the Clinician Investigator track most certainly requires some level of extramural funding. Promotion along the Clinician Educator track most certainly requires teaching evaluations from as many students and learners as possible.

6. General timelines: Almost all PEM practitioners are non-tenured, which means there is no clock or threat of job loss if you do not get promoted, which has its pluses and minuses. On average, promotion process begin on the 7th year of being assistant professor and 9th year of being associate professor, though this can vary widely depending on your personal and professional needs. The actual process is lengthy and can last up to a year.

7. Thresholds: Duke University is the only university I’ve found so far that publicly states the number of publications required for promotion to Associate Professor for a Track called Researcher-ClinicianPractitioner-Teacher: 15. This includes 5 or more first- or senior-authored papers.

8. Documents: Obviously a Curriculum Vitae. There is also a Statement of Work, a 1 to 3 page manifesto-like essay that details how you used your time as faculty to achieve the different elements of scholarship (Clinical, Education, Research, Service) and brag about your work products. Clinician Educators must also turn in an Educator’s Portfolio which highlights educational work products and student / learner feedback about you. Each university will have its list of required forms and paperwork, because that’s just how this world works.

Do you have Promotion Preparation questions, comments, or experiences you’d like to share? Post them here. Good luck!

Todd P Chang

Todd is the Director of Technology for the INSPIRE Network with David Kessler & Marc Auerbach. Todd was formerly the Faculty Advisor and Head Site Administrator for the website's predecessor, pemfellows.com. He lives in Pasadena, CA, with his partner and 2 ridiculous cats that are probably sitting on his head as you read this.